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FDA-approvedPrescription only
Cold Sore Treatment (valacyclovir or acyclovir)
Prescription — short oral antiviral course, started at the first tingle
A short oral antiviral for recurrent cold sores, most useful when it starts at the first tingle — which is why people keep a course on hand. Sent to a local pharmacy if prescribed.
FDA-approved for the treatment of cold sores (herpes labialis) — valacyclovir in adults and adolescents, and acyclovir for herpes simplex infections of the skin and mucous membranes. Prescribed by a licensed provider only if appropriate for you.
From$99$32 consultation included, not refunded · medication paid at your pharmacy, if prescribed
Choose your plan
One-time
Price
$99for the provider visit — medication paid at your pharmacy, if prescribed
Includes your $32 provider consultation (non-refundable). If your provider decides treatment isn’t appropriate, the rest is refunded automatically.
- Picked up at a local pharmacy you choose. If prescribed, the medication itself is paid for at the pharmacy; the price here covers the provider visit.
- Your provider confirms the dose. If they start you on a lower step, we refund the difference; if they choose a higher one within the same plan, the price you paid stands.
Adding to cart books a provider visit. You pay the shown total; the provider decides; the medication portion comes back automatically if they say no.
Questions
Will I definitely be prescribed this?
No. A consultation does not guarantee a prescription. A licensed provider reviews your history — eye involvement, immune status, kidney function — and prescribes only if it is appropriate for you; if it isn't, they will say why. If prescribed, the prescription is sent to a local pharmacy and you pay for the medication there; what you pay here is the consultation.
Is a prescription antiviral different from the cream at the pharmacy?
The over-the-counter cream is docosanol, which works on the outside of the cell to block the virus entering; the oral antivirals work inside infected cells to stop the virus copying itself. A provider prescribes an oral course where it fits your pattern, and may still suggest the cream as an adjunct.
Can I take it every day to stop outbreaks?
Daily suppressive dosing exists and is a provider's decision, usually for people with frequent or severe recurrences. Raise it at the visit; this particular exam covers an episodic course, and suppression may need its own review.
How it works
Cold sores are herpes simplex virus, usually type 1, which after the first infection retreats into the nerve cells that supply the lip and stays there for life. Sun, illness, stress or a period wake it, it travels back down the nerve, and the tingle, blister and crust follow. Valacyclovir is a prodrug: absorbed from the gut, it is converted to acyclovir, which does nothing in a healthy cell. Inside a cell the virus has infected, a viral enzyme — thymidine kinase — activates it, and the cell's own enzymes finish the job, producing a molecule that the virus's DNA polymerase mistakes for a normal building block. Once incorporated, the growing viral DNA strand can go no further. Because only infected cells activate the drug, its action is selective; because it works by stopping replication, it does the most when replication is just starting — the prodrome — and little once the blister has fully formed. It does not remove the latent virus from the nerve, which is why cold sores recur and why a provider may discuss daily suppressive dosing for people who get them often.
The full mechanismA provider may consider it if
- Recurrent cold sores you recognise from the first tingle or itch
- You want a course on hand so treatment can start at the prodrome rather than after a pharmacy trip
- Outbreaks frequent enough that a provider may consider suppressive dosing
It won’t be prescribed if
- A sore near or in the eye, or any eye pain, redness or sensitivity to light alongside a cold sore — herpes in the eye can damage sight and needs same-day in-person care; call 911 or go to an emergency department for sudden vision loss
- Widespread blisters, blisters spreading over eczema-affected skin, or a cold sore with fever and feeling unwell — eczema herpeticum and disseminated infection are treated in person, urgently
- A weakened immune system — HIV, transplant medication, chemotherapy — where dosing and monitoring differ and the visit belongs with your specialist
- Kidney disease — the dose must be adjusted and the provider needs your kidney function before prescribing
- A known allergy to valacyclovir or acyclovir — this is a hard stop
- A first-ever outbreak with severe mouth ulcers, or sores that have not healed in two weeks — needs examination
- Under 18 — online treatment here is for adults
These are the same checks your provider runs in the visit. If one applies, they will tell you plainly — and the medication portion of what you paid comes back automatically.
What to expect
After your visit
If prescribed, the prescription is sent to a local pharmacy you choose and you pay for the medication at the counter. What you paid here covers the consultation.
At the first tingle
Start the course as soon as the prodrome begins — the label regimen for valacyclovir is a single day. Drink water through it; the drug is cleared by the kidneys.
Days 2–7
A treated episode typically runs its course somewhat faster and smaller than an untreated one; healing still takes days. Frequent outbreaks are the conversation to have about suppression.
Safety
Side effects, before you decide
Headache, nausea and abdominal pain are the common ones. Less often: dizziness, and confusion or hallucinations, mostly in older people or those with reduced kidney function. Rarely the drug can crystallise in the kidneys, especially at high doses with poor hydration, and in people with severely weakened immunity high doses have been linked to a serious blood disorder. A rash, or any change in urine output, means stop and message your provider.
- FDA prescribing information (DailyMed): Valtrex (valacyclovir hydrochloride) — indications, clinical pharmacology, warnings on acute renal failure and CNS effects, adverse reactions; current label as of 2026
- FDA prescribing information (DailyMed): acyclovir — indications and warnings; current label as of 2026
- Spruance SL, Jones TM, Blatter MM, et al. High-dose, short-duration, early valacyclovir therapy for episodic treatment of cold sores: results of two randomized, placebo-controlled, multicenter studies. Antimicrob Agents Chemother. 2003;47(3):1072–1080
Complete safety information is provided during your visit and with every prescription. This page is a summary, not a substitute for your provider's advice.
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See whether cold sore treatment (valacyclovir or acyclovir) is right for you.
A licensed provider reviews your visit and decides. You receive medication only if prescribed, and that portion of your payment is refunded automatically if they say no.